February 1, 2013

Electrocardiography is typically the test of choice in the initial evaluation of patients with chest pain. In most cases, clinical impression, which is shaped by the presenting symptoms, physical examination, initial electrocardiography, and the patient's risk of acute coronary…

Hereditary hemochromatosis causes a toxic accumulation of iron in vital organs, and can lead to cirrhosis, cardiomyopathy, and hepatocellular carcinoma. Most patients are homozygous for the HFE gene mutation C282Y. Diagnosis requires elevated serum ferritin levels and…

Guillain-Barré syndrome causes progressive, relatively symmetrical weakness with decreased myotatic reflexes. Although the disease is uncommon, respiratory compromise and disability occur in some patients. Early diagnosis and hospitalization significantly improve outcomes.

Treatment recommendations updated to be consistent with new CDC guidance. The article “Diagnosis and Management of Gonococcal Infections” (November 15, 2012, p. 931) noted that first-line antibiotic therapy for uncomplicated gonococcal infections includes intramuscular…

MedWatch: FDA Warns Against Combining CNS Depressants with Xyrem | CDC Study Documents New HIV Infections Based on Race and Ethnicity | Proposed Rule Would Expand Veterans' Access to Non-VA Physicians | Researchers Evaluate Medical Education Debt and Students' Choice of Specialty

The personal side of medicine told from the patient's perspective. The patient's story is followed by commentary from a physician and a list of resources.

Proactive support in many forms, provided by health care professionals or laypersons, increases the duration of any breastfeeding (including partial and exclusive) and exclusive breastfeeding. Face-to-face support is superior to telephone-based interventions. Support for…

Hyaluronic acid injection does not improve pain in patients with knee osteoarthritis but may result in serious adverse effects.

Symptom-based dose adjustment of inhaled steroids resulted in similar treatment outcomes compared with a dosing strategy based on physician assessment using widely distributed standard national guidelines, and compared with a biomarker-based strategy using exhaled nitric oxide.

Advisory Committee on Immunization Practices (ACIP) Releases 2013 Immunization Schedules. First, the format of the routine child and adolescent schedules has changed and the two previous age-based schedules (0 to six years and seven to 18 years of age) have been merged into…

Fidaxomicin (Dificid) is an oral macrolide antibiotic labeled for the treatment of Clostridium difficile–associated diarrhea in adults. It primarily exhibits activity against species of clostridia, mainly C. difficile, while having no or limited activity against normal…

National Institutes of Health (NIH) funding to family medicine departments is very low and has an inverse association with the production of family physicians at these medical schools. Clinical and Translational Science Awards and other efforts to include primary care in NIH…

Photo Quiz presents readers with a clinical challenge based on a photograph or other image.

Calcium supplements are widely used in the United States and other developed nations, most commonly to reduce the risk of fracture in women with low bone mineral density.1–3 However, concern has been expressed that calcium supplementation may increase the risk of…

Use of calcium supplements produces small, beneficial changes in blood pressure and circulating lipid levels.1,2 To determine whether these changes lead to fewer acute myocardial infarctions (MIs) and strokes, we prespecified cardiovascular outcomes as secondary end points in a…